So, you are saying a totally corrupt system, and bought politicians, have sent the US into a death spiral where working people are expendable meat who only matter to the degree that money can be extracted from them?

No, I'm not saying that.

I'm saying that many millions of people have stable, decent-paying, often middle-class jobs working in the health care sector. They will be negatively affected (significantly so) if we were to make significant reductions in health care spending. So it is politically infeasible to slash health care spending down to the levels of European countries (ie. something close to half of current levels).

There are many millions of people that have health care insurance coverage that is better than average - either better than average coverage or higher than average employer contributions. Many millions will have both, concentrated heavily in unionized jobs and public sector employment. So it is politically infeasible to provide a single-payer system that has health care coverage that isn't better than average.

Since both of the foregoing are true, it is impossible to convert to a single-payer system - which has to cover the extra expenses of both giving coverage to the currently uninsured and under-insured and now raise all the people with below-average coverage up to above-average coverage - without significantly increasing how much we spend on health care. And it is politically infeasible to impose taxes to pay for that.

None of that has anything to do with a corrupt system or bought politicians. As a matter of public policy, we have encouraged medical sector employers to provide decent wages to their employees, encouraged the development of "eds and meds" as a redevelopment and employment solution, and encouraged employers to provide generous health care plans through tax deductibility of medical insurance payments. That's not due to corruption or bought politicians.

Plus, you have to add in a health dollop of Baumol's Cost Disease, which health care is going to greatly suffer from. The richer a country gets, the more expensive services that can't be made more labor-efficient will get. We pay more for health care in the US because we have have a much more efficient labor force than other countries, so the salaries paid to health care workers have to rise more than in other countries even though they can't/don't provide medical services more efficiently.

There's no villain. I mean, there are villains - there's villains in every sector of the economy. But there's no villain that's keeping us from switching. It's just millions of ordinary people who don't want to get hurt by what we would have to do to make the switch.